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On the Front Line with a Silver Lining Foundation
DR SANDY GOLDBERG
Dr. Sandy Goldberg, the organization’s founder, provides comprehensive breast health services for all of Chicago.

What does a life cost? That is the substantial question plaguing medical professionals like Dr. Sandy Goldberg in an era where access to health care is more commonly debated on the legislative floor than in a doctor’s office. Without proper funding or access to services, many people face an increased risk of a fatal diagnosis, especially regarding cancer.  

A Silver Lining Foundation hopes to change that. Founded in Chicago in 2006, A Silver Lining provides medical information and comprehensive testing for breast-health services including screening mammograms, diagnostics, ultrasounds, MRIs, and breast biopsies. In their first year, A Silver Lining funded 95 screening mammograms. In the first eight months of 2018 alone, they funded nearly 1,200 mammograms. People who are uninsured and people who are underinsured can find relief through A Silver Lining’s numerous programs, including Keep aBreast, an interactive breast-awareness program for young women, and Survive to Thrive, a program tailored toward cancer survivors and their post-treatment care.

All of this is part of Goldberg’s inclusive vision. “If it involves breast-health testing, we will help you,” Goldberg says. “We don’t turn anybody away.” Goldberg chatted by phone with Cancer Wellness to share the unlikely origins of A Silver Lining, and why the organization’s work is critical to the health and survival of people in underserved communities in Illinois.

What was the impetus for starting A Silver Lining Foundation?

I had been diagnosed with breast cancer. I was extremely fortunate to have great insurance and extraordinary support. I was able, through a relationship with the American Cancer Society, to start a little call-in cable show on CAN-TV’s Hotline 21. I was the host interviewing specialists in the field of cancer and people could call in. What I learned kind of boggled my mind in a short period.

Number one, I learned people were using our show as their primary care physician, and the number of calls outpaced the show. I would call everybody back, and I discovered people felt they weren’t worthy to even attempt to access care because they had no money and no insurance. One night, I went home and my husband said, “How are you?” And I went, “Good.” I started crying, and he said, “What’s going on?” And I said, “It’s not fair.” My husband is a very pragmatic man. He said to me, “OK. So what do you want to do about it?” And I said, “Start a foundation.” And he said, and pronouns are very important to me, “Then we will.” And that’s how we started—at our kitchen table with one $125 donation.

We reached out to multiple organizations, some of which have a national footprint. So if people needed any information, they could tell them to come to us. Mayor Daley heard about our work, and he [connected us with] 311, a Chicago city services phone number. When they call 311 and say, “I need a mammogram. I don’t have insurance. I feel a lump in my breast. I don’t know where to go,” they’re given our number. We’re the only major metropolitan area in the entire country that does this.

One day, I said to our board, “It’s really cool what we’re doing, but we ought to do more on the frontline.” That means funding mammograms. I’m not talking about research. I’m talking about funding and front-of-the-line testing.

The first hospital that believed in our mission was the University of Illinois Chicago. We created the template there that we use to this day with our 15 partner hospitals (which includes Presence St. Joseph and Mount Sinai).

Later, I thought, “What about people who need follow-up testing?” And we started funding diagnostic testing. Now we fund from soup to nuts and up the food chain: screening mammograms, diagnostics, ultrasounds, MRIs, and breast biopsies. If any of our ladies or men are diagnosed, our hospital partners either get them into a funded program, or the hospital’s charity program picks up the cost after diagnostic testing. Nobody pays the bill.

Why is equal access to health care an issue that continues to be ignored in the general public?

DR SANDY GOLDBERG Photo by Jack Saxe-Staral

I think our nation is being run by bean counters. Our country is also being driven by individuals who never in their life have had to worry about feeling a lump. I think we have become an increasingly uncaring society. I think we have become a society in which we try to take care of our own, and no one else exists. I cannot tell you how many times people have said to me, “But everybody’s supposed to have insurance.” Well, everybody’s supposed to be able to eat. Everybody’s supposed to be able to take care of their kids, and everybody’s supposed to have a roof over their heads. But that is not the case for the world today and certainly not for the United States. Everyone asks, “How much is it going to cost?”

What have you found to be the most effective way of addressing the equity gap?

Everything we do at A Silver Lining is organic. We do the best we can concerning leveling the playing field. Everybody’s entitled to be treated like a human being. Everybody’s entitled to be treated with respect. That’s what we’re about. I think the equity gap is enormous, number one. I don’t know if any organization is able to address it correctly and entirely. But with us, everybody is welcome. We will help you. If it involves breast-health testing, we will help you. We’re a small foundation, but we certainly do the best we can. We don’t turn anybody away.

How do you find your patients?

Fewer organizations are on the front line. We all work together. We have like 50 referral sources. They’re from free clinics. They’re from the American Cancer Society. They’re from all over, so we work together. And conversely, we’ve had people call from other states. We work together, so when you’re talking about who do we support—everybody supports everybody. If you have any kind of a heart, you help everybody. Our goal is to be able to receive those who need testing regardless of the source.

How has A Silver Lining developed over time?

Initially, we provided screening mammography, which eventually expanded to include breast-health testing, which has expanded to include different types of breast-health testing. I sat with people in breast radiology, and we tried to figure out what we needed to be able to fund. That is what we do.

But other programs have developed under the model of A Silver Lining. Someone in the office said, “You know, there’s no funding in schools anymore. No health classes are being taught.” So we created a breast-health testing program. And we go anywhere that we’re invited to talk to young women about breast-health testing. How do you do a breast-health exam on yourself? What are the myths surrounding diagnosis or the likelihood of being diagnosed? What can you do to lower your risk factors? It has proved to be a very successful program in many ways. Much of it has to do with the fact that we stress, strongly, to young women to advocate for themselves. And our goal as well, which has proven to be successful, is for these young women to go home and tell their communities and their families what they’ve learned. It’s worked so well that we’ve also created an adjunct program for adult women.

One day, I got a call, and they said, “Dr. Sandy, I have health insurance. I’m a survivor. A breast cancer survivor. I have health insurance.” And I said, “Well, this is wonderful. Can I ask what the problem is?” And they said that the only thing their health insurance would cover is a screening mammogram. “I don’t have a breast.” I hung up the phone and called one of our donors and said, “This is unconscionable. We have to create some kind of program for survivors.” And from that came Survive to Thrive—we fund breast-health testing for survivors who otherwise wouldn’t know their health condition. Everything is a response. We had initially only funded uninsured women. And then all of sudden, we’re getting calls from women who say, I did the right thing. I bought insurance. I did what I’m supposed to do. And guess what? My insurance doesn’t cover preventative care. Or, guess what, they’ll only cover a screening mammogram. They won’t cover a biopsy because I’m under the age of 40. So again, this is outrageous. So we added an underinsured program. I can’t afford my deductible. I can’t afford my co-pay. I can barely pay my rent. I can barely feed my kids. And I have to come up with a $6,500 co-pay? So this is the sort of things we respond to in terms of how we operate here.

How do you hope to grow the foundation in the future?

We don’t take money from the state, and we don’t accept funding from the federal government. We will not do so. And the reason we won’t do so is that we don’t want anybody telling us who we can help. There are other organizations—extraordinary organizations—who have been working with the federal government and the state for years. All of a sudden their funding is slashed. And where are their ladies going to go? So they send them to us.

In the first eight months of the year, we funded 1,185 women. Approximately three to four of them should have been diagnosed with breast cancer. That’s pretty much the average statistic. We had 30 diagnosed. Thirty. So this speaks to the fact that women have not been able to get access, have been suffering for a long time, do not have the money to do it, do not know where to go. We have many, many more women we should be helping. Do I sound like I’m preaching? Yes, I am.

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